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- Title
Racial, Ethnic, and Gender Diversity Among Academic Surgical Leaders in the US.
- Authors
Iwai, Yoshiko; Yu, Alice Yunzi L.; Daniels, Nikki C.; Manik, Ritika; Thomas, Samantha M.; Sudan, Ranjan; Beasley, Georgia M.; Fayanju, Oluwadamilola M.
- Abstract
This cross-sectional study examines racial, ethnic, and gender diversity of leadership in surgery departments at US medical schools. Key Points: Question: How does the racial, ethnic, and gender diversity among academic surgery department leaders in the US differ across roles and surgical specialties? Findings: In this cross-sectional study of 2165 faculty at 165 surgical departments in the US and Puerto Rico, males outnumbered females across all leadership roles, and only 8.9% of leaders were of racial or ethnic groups underrepresented in medicine (URiM). Females and URiM surgical leaders were disproportionately clustered in roles such as vice chair of diversity, equity, and inclusion or vice chair of faculty development. Meaning: Findings of this study suggest that females and URiM leaders are disproportionately clustered in roles that may not translate into future promotion. Importance: Surgical department chairs remain conspicuously nondiverse despite the recognized importance of diverse physician workforces. However, the extent of diversity among non-chair leadership remains underexplored. Objective: To evaluate racial, ethnic, and gender diversity of surgical department chairs, vice chairs (VCs), and division chiefs (DCs) in the US. Design, Setting, and Participants: For this cross-sectional study, publicly accessible medical school and affiliated hospital websites in the US and Puerto Rico were searched from January 15 to July 15, 2022, to collect demographic and leadership data about surgical faculty. Two independent reviewers abstracted demographic data, with up to 2 additional reviewers assisting with coding resolution as necessary. In all, 2165 faculty were included in the analyses. Main Outcomes and Measures: Proportions of racial, ethnic, and gender diversity among chairs, VCs, and DCs in general surgery and 5 surgical specialties (neurosurgery, obstetrics and gynecology, ophthalmology, orthopedics, and otolaryngology). Results: A total of 2165 faculty (1815 males [83.8%] and 350 females [16.2%]; 109 [5.0%] African American or Black individuals; 347 [16.0%] Asian individuals; 83 [3.8%] Hispanic, Latino, or individuals of Spanish origin; and 1624 [75.0%] White individuals as well as 2 individuals [0.1%] of other race or ethnicity) at 154 surgical departments affiliated with 146 medical schools in the US and Puerto Rico were included in the analysis. There were more males than females in leadership positions at all levels—chairs (85.9% vs 14.1%), VCs (68.4% vs 31.6%), and DCs (87.1% vs 12.9%)—and only 192 leaders (8.9%) were from racial or ethnic groups that are underrepresented in medicine (URiM). Females occupied more VC than chair or DC positions both overall (31.6% vs 14.1% and 12.9%, respectively) and within racial and ethnic groups (African American or Black females, 4.0% VC vs 1.5% chair and 0.6% DC positions; P <.001). URiM individuals were most commonly VCs of diversity, equity, and inclusion (DEI, 51.6%) or faculty development (17.9%). Vice chairs of faculty development were split equally between males and females, while 64.5% of VCs for DEI were female. All other VCs were predominantly male. Among DC roles, URiM representation was greatest in transplant surgery (13.8%) and lowest in oral and maxillofacial surgery (5.0%). Except for breast and endocrine surgery (63.6% female), females comprised less than 20% of DC roles. Nearly half of DCs (6 of 13 [46.2%]) and VCs (4 of 9 [44.4%]) had no female URiM leaders, and notably, no American Indian, Alaska Native, or Native Hawaiian or Other Pacific Islander individuals were identified in any surgical leadership positions. Conclusions and Relevance: While it is unclear whether promotion from VC to chair or from DC to chair is more likely, these findings of similar gender distribution between chairs and DCs suggest the latter and may partially explain persistent nondiversity among surgical chairs. Female and URiM surgical leaders are disproportionately clustered in roles (eg, VCs of DEI or faculty development) that may not translate into future promotion to department chairs.
- Publication
JAMA Surgery, 2023, Vol 158, Issue 12, p1328
- ISSN
2168-6254
- Publication type
Article
- DOI
10.1001/jamasurg.2023.4777